Objectives The National Organ Transplant Unit was established in 2006 with the aim of providing renal and corneal transplants services. This study assessed the current state of the National Organ Transplant Unit and the organ donation experience at a single centre intensive care unit in Trinidad. Methods A review of legal, human and material resources and a retrospective chart review of the current status of organ donation and transplantation in Trinidad and Tobago was conducted. Data were collected from medical records of deceased donors for the period January 2006 to December 2020. The organ donor experience in the Adult Intensive Care Unit at a tertiary care hospital in Trinidad was also evaluated. Data were collected from medical records of all patients in the adult intensive care unit for the period October 2016 to December 2016. Results Trinidad and Tobago has four donor hospitals, one transplant centre, and one surgical team consisting of three surgeons, approximately 100 trained Transplant Procurement Managers and one trained laboratory technician. The deceased donation rate was 0.77 donor per million population in 2006, peaked in 2014 at 3.85 and then remained at 0.77. Donor potentiality for the adult intensive care unit was 66.7% with a donation rate of 5.3%. Conclusions Organ donation in Trinidad and Tobago mostly relies on living donors. Despite increases in organ donation and conversion rates, the country has not yet achieved self-sufficiency. The implementation of a taskforce dedicated to developing action plans to improve organ donation services may assist the country in achieving self-sufficiency.